- 作者：Tahziba Hussain ; tahziba_hussain@hotmail.com" class="auth_mail" title="E-mail the corresponding author
- 关键词：Pleural effusion ; Case report ; TB ; Relapse
- 刊名：Egyptian Journal of Chest Diseases and Tuberculosis
- 出版年：2016
- 出版时间：October 2016
- 年：2016
- 卷：65
- 期：4
- 页码：859-861
- 全文大小：466 K
Case presentation
A 45 year old female patient had the typical signs and symptoms of tuberculosis with continuous coughing, breathlessness and protruded abdomen. The USG abdomen showed fluid in the left pleural space. Thoracocentesis was carried out thrice at an interval of 15 days and about 5.15 L were aspirated. The symptoms of dyspnea and cough were relieved. There was acute drug reaction after starting the ATT. The blood pressure was very high requiring hospital admission. The patient was monitored during the entire course of treatment. No fluid in the bilateral pleural spaces was observed in USG after 6 months of treatment.
This patient had spinal tuberculosis 8 years ago and had recovered following ATT. Therefore, it is difficult to say whether pleural effusion was due to relapse of a previous infection or a re-infection. It is also not known whether TB patients remain susceptible to yet another infection in some other extra-pulmonary site.
Conclusion
Abdominal TB should be suspected in patients with fever, abdominal pain and ascites. Sputum induction (in addition to pleural fluid) for acid-fast bacilli and culture is a recommended procedure in all patients with TB pleurisy.
This condition carries good prognosis, if promptly diagnosed and treated. A reasonable management strategy for pleural TB would be to initiate a four-drug regimen and perform a therapeutic thoracocentesis in patients with large, symptomatic effusions. Prolonged follow-up is essential in cases of pleural effusion, as in the presented case.